Abstract
BACKGROUND: Limited studies demonstrated the relationships between first-trimester maternal dyslipidemia and adverse pregnancy-offspring complications. This investigation aimed to probe (1) the relationships of first-trimester maternal dyslipidemia with adverse pregnancy and birth outcomes, and (2) the potential influence of first-trimester maternal lipid profiles on offspring growth trajectories. METHODS: A prospective observational investigation was conducted within the structure of the Tianjin Birth Cohort, in which maternal blood samples were acquired (median at 11th gestational week) to measure lipid levels. Group-based trajectory modeling was employed to classify latent offspring growth trajectories. Poisson regression incorporating robust standard error was employed to analyze the associations of maternal dyslipidemia with adverse pregnancy-offspring complications. RESULTS: First-trimester maternal dyslipidemia significantly increased gestational diabetes mellitus risk after adjustment for confounders (relative risk: 1.36, 1.20–1.54), but did not link to gestational hypertension (1.13, 0.89–1.43) risk. In addition, first-trimester maternal dyslipidemia elevated preterm birth (1.24, 1.03–1.49) and large for gestational age (1.27, 1.12–1.43) risks. However, first-trimester maternal dyslipidemia showed no significant link with either small for gestational age risk (0.83, 0.67–1.03) or offspring growth trajectories from birth to 24 months (lower growth trajectory: 0.99, 0.93–1.06; higher growth trajectory: 0.97, 0.88–1.08). CONCLUSIONS: First-trimester maternal dyslipidemia elevated adverse pregnancy and offspring status risks, specifically maternal gestational diabetes mellitus, as well as offspring preterm birth, and large for gestational age, but did not link to maternal gestational hypertension, small for gestational age, or variations in offspring growth trajectories from birth to 24 months. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12944-025-02751-y.